Objective: Data are presented from a pilot research program initiated to develop, refine, and test the outcomes of problem-solving therapy that targets the needs of older adults with minor depression in home care settings. Method: A pilot randomized clinical trial compares the impact of problem-solving therapy for home care to treatment as usual…

Context: Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail. Purpose: To examine urban-rural differences in Medicare HHC utilization. Methods: The 2002 100% Medicare HHC claims and denominator files were…

Purpose: The authors examine differences in reports of residual disability and unmet need by type of long-term care arrangement (assistive technology or personal care).Design and Methods: This study compares three specific dimensions of residual difficulty (pain, fatigue, and time intensity) and reports of unmet need across care arrangements.…

Practitioners, researchers, and policy makers have attempted to improve the delivery of in-home service to the frail elderly through the expansion or merger of existing care providers or through the creation of coordinating units. To investigate the feasibility and effectiveness of a third approach to in-home services, 68 older adults (mean age,78…

This document updates a recent report by the General Accounting Office (GAO) which compared Medicare catastrophic health insurance proposals. The update includes H.R. 2470, as passed by the House of Representatives and S. 1127, as reported by the Senate Committee on Finance. An introduction explains the roles of Medicare, Medicaid, the Veterans…

Describes a diversified approach to delivering home care to vulnerable older people. This pilot program, funded by the Massachusetts Department of Elder Affairs, attempted to reduce the demand for scarce homemaker services. Results suggest homecare diversification did not alter consumer satisfaction but increased manager time. (Author/JAC)